Dr. Daniel J. Givens
Nonsurgical Rhinoplasty vs. Surgical Rhinoplasty
Updated: Jul 13, 2021
Who is an appropriate candidate for Nonsurgical Rhinoplasty (AKA Filler Rhinoplasty or Liquid Rhinoplasty)? What is a Nonsurgical Rhinoplasty? Tell me what I need to know!
A Nonsurgical Rhinoplasty uses injectable filler to improve the appearance of the nose. While several types of filler can be used, I prefer to use HA (Hyaluronic Acid) based fillers such as RHA4, Versa, and Restylane Lyft. These fillers are smooth, natural feeling and looking, and results last about one year. This procedure is performed in the office, there is minimal bruising and swelling, and results are instantly visible.
Who is an appropriate candidate for Nonsurgical Rhinoplasty? In general, a nonsurgical rhinoplasty aims to improve the appearance of a "dorsal hump" or a bump on the top of the nose. When the starting point called the "radix" sits low, it can be brought up to camouflage the appearance of a dorsal hump. The area below the dorsal hump called the "supratip" can also be brought up, further improving the appearance. Finally, a droopy nasal tip can be re-shaped, causing a nice improvement.
In this picture above, the patient has a dorsal hump but also a low radix, which makes her an ideal candidate for a nonsurgical rhinoplasty. This area was smoothed with filler. Minimal filler was used below the dorsal hump because I wanted to preserve a small "supratip break" which is a pleasing characteristic of the nose and allows the tip to appear refined and stand alone from the dorsum.
In contrast, a surgical rhinoplasty is the traditional "gold standard" procedure which is performed to reshape the nose. I perform this procedure under general anesthesia, meaning that the patient is fully asleep. This is necessary because I use a technique called "open structure rhiniopasty" which means that the skin is lifted, revealing the bone and cartilage beneath. The bone can be shaved or straightened, and the cartilage can be trimmed, repositioned, or augmented with structural grafts. These techniques allow for maximum and permanent changes to the appearance of the nose.
Who is a good candidate for a surgical rhinoplasty? Patients who want a permanent change, patients who have a large amount of twisting or a crooked appearance, and patients with thicker skin that resists movement due to filler all may benefit from a surgical rhinoplasty. Additionally, patients who have difficulty breathing should consider surgery to help improve nasal airflow.
This patient in the picture above had a surgical rhinoplasty to improve the appearance of his nose. His radix was not low, and it would not have been the best choice to use filler to camouflage his dorsal hump because it would have brought the height of the nose up too much. In this case, his dorsal hump was trimmed, and the nasal tip was defined with a shield graft, smoothing the cleft between the tip cartilages.
What is the recovery from a surgical rhinoplasty? I discuss with patients that surgical rhinoplasty has a very visible recovery. For the first week, there is a cast on the outside of the nose, and there may be mild bruising present if the bones were re-fractured. Patients are puffy and swollen for about 6 weeks afterwards. During the first three weeks, it is apparent to anyone that the nose is swollen. For the next three weeks, friends and family can tell that there is still swelling, but it is less apparent to someone that does not know your face. Changes and refinements continue to occur even out to one year after surgery.
In the picture above, the dorsal hump was reduced, the tip was slightly elevated and set back, and refined, and the alar base was slightly reduced.
How do you choose between a nonsurgical rhinoplasty and a surgical rhinoplasty? It is important to consider the following questions:
Am I willing to have some healing time in order to see permanent changes to my appearance? (surgical)
Would I prefer yearly touch-up injections so that I do not have to undergo a big procedure? (nonsurgical)
Am I limited by cost in the short-term? (nonsurgical)
Do I want to see maximum improvement in multiple areas of the nose? (surgical)
Am I okay with subtle improvements in appearance? (nonsurgical)
Despite the above, not everyone is a candidate for either a nonsurgical or a surgical rhinoplasty in Dubuque. As a board-certified facial plastic surgeon in Dubuque, Iowa, I perform both of these procedures, and can assist patients during consultation to determine which is the best option for them. If your injector does not perform surgical rhinoplasty, or your surgeon does not perform filler rhinoplasty, it may be worth a second opinion from a board-certified facial plastic surgeon who routinely performs both of these procedures.
Dubuque is located in Easern Iowa, where Iowa meets Illinois and Wisconsin on the Mississippi River. Patients travel from the Des Moines area in central Iowa, from the Chicago suburbs, and from towns and cities such as Cedar Rapids, Waterloo, Davenport, Platteville, and Galena to my practice to see me for rhinoplasty and nonsurgical rhinoplasty. Consults can be scheduled by calling 563-239-9039 and by emailing email@example.com.